Abstract
Paralympic sport is growing rapidly, yet evidence-based nutritional guidelines for Paralympic athletes remain limited. Existing sports nutrition recommendations are largely derived from research in able-bodied athletes and may not account for the unique physiological characteristics, body composition, and energy requirements associated with different impairments. This thesis therefore investigated key aspects of sports nutrition in Paralympic athletes, including energy expenditure, resting metabolic rate, body composition, bone health, and glucose regulation, with the aim of providing a scientific foundation for tailored nutritional guidelines.
The findings showed that total energy expenditure varies considerably among Paralympic athletes and is primarily influenced by fat-free mass, exercise volume, and the presence of spinal cord disorders. Novel prediction equations were developed to estimate total daily energy expenditure and resting metabolic rate more accurately in this population. Furthermore, dual-energy X-ray absorptiometry proved feasible for assessing body composition, whereas traditional skinfold assessments were less practical due to disability-related limitations. The thesis also demonstrated a high prevalence of low bone mineral density at the hip, particularly among wheelchair-dependent athletes, highlighting the importance of mechanical loading for bone health. While low bone mineral density at the spine was absent among athletes participating in wheelchair sports like wheelchair tennis and basketball. Finally, continuous glucose monitoring revealed generally stable glucose regulation in Para cyclists, although athletes with spinal cord disorders appeared more susceptible to nocturnal hypoglycemia. Furthermore, the placement of the continuous glucose monitor influenced the reliability of the measurements during exercise. In summary, this thesis provides practical tools and new scientific insights to support individualized, evidence-based nutritional counseling for Paralympic athletes and contributes to the development of future Paralympic nutrition guidelines
Defence date: 02/09/2026
